I am committed to integrating my experience and background in basic microbiology and infectious disease research with my training in occupational and environmental health so as to better understand the complex relationships between exposure to infectious agents in the workplace and the subsequent development and/or spread of disease related to these exposures. While my experience here to date has put me in an excellent position to become an independent investigator, I still need additional training (formal coursework and mentoring) in occupational and agricultural health, which this Award would provide. This would assist me in meeting my immediate career goals (focusing time on the research proposed in this application, and taking additional coursework in Occupational and Environmental Health in order to broaden my background in these areas), as well as my long-term goals of gaining recognition as a leader in this field, and eventually becoming a full Professor with tenure. Environment The Department of Occupational and Environmental Health is comprised of 19 primary faculty from a wide variety of disciplines. This diverse group of faculty members brings in $14 million in extramural funding each year. Funding comes from a wide range of federal and state agencies, as well as from private foundations. Lead funders include the National Center for Injury Prevention and Control, National Institute for Occupational Safety and Health, the National Institute of Environmental Health Sciences, and the Environmental Protection Agency. The Department and selected mentors are leaders in the study of rural health, including agricultural health and medicine. Research Plan A recent report has documented the clinical impact of methicillin-resistant Staphylococcus aureus (MRSA), suggesting that MRSA caused over 94,000 invasive infections and more than 18,000 deaths in the United States in 2005, eclipsing HIV as a leading infectious disease killer. In 2005, the majority of these infections were associated with healthcare exposure;however, this trend is changing. Community-associated MRSA strain USA300 was recently found in 31.5% of invasive MRSA isolates collected from US metropolitan areas. As the epidemiology of MRSA has changed, new groups at risk of acquiring MRSA have emerged. Initially individuals with health care contact were the main risk group for MRSA carriage and infection;however, in the past decade, athletes, injection drug users, and prisoners have also emerged as groups at risk of MRSA infection. Reports from Europe and Canada have reported another potential MRSA risk group: individuals in contact with livestock and poultry. As pilot studies by our group have documented the presence of MRSA in US swine, we seek to expand upon this research and examine the epidemiology of Staphylococcus aureus more broadly in individuals with occupational exposure to livestock and poultry. Our primary objectives are to determine the prevalence of S. aureus (including MRSA) on Iowa livestock and poultry farms, sampling from animals, human workers, and the environment. We will examine 30 farms during this research, including farms with live swine, cattle, and poultry. In the second part of our research plan, we will examine transmission of S. aureus by colonized farmers to close family contacts, in order to determine movement of organisms to individuals lacking occupational exposure. Finally, we will partner with rural physicians working in areas of high livestock concentration, in order to examine symptomatic infections caused by S. aureus in individuals with occupational exposure. Our central hypothesis is that individuals working in close proximity to livestock and poultry will be at risk of occupational exposure to S. aureus, and that this organism will be transmitted to spouses and other family members in close contact to the worker. We further hypothesize that farmers in contact with livestock (and swine in particular) will be likely to be colonized with "swine-associated" strains (such as ST398), and that these strains will also be found in symptomatic infections identified by our rural physicians. Findings from this research will allow us to plan interventions to reduce occupational exposure to this organism, and implement such interventions in future studies. PUBLIC HEALTH RELEVANCE: Methicilin-resistant Staphylococcus aureus (MRSA) has been found in a high proportion of swine and swine workers in studies carried out in Europe and Canada. Recently, our group has identified MRSA in a small study of swine and farmers in Iowa and Illinois. We seek to determine how common MRSA colonization and infection are in Iowa livestock, and to determine if livestock exposure represents a new occupational risk factor for MRSA colonization and infection.